Thought about taking up a musical instrument? Need another reason to encourage your children to play music? It could be good for the brain in the long term, helping to reduce mental decline. And with people living to older ages, it’s not surprising there’s an avid interest in anything that may slow down mental decline.

Mental decline is different from dementia. It is something that affects all of us; there’s evidence that a gradual decline in memory and thinking abilities starts in early middle-life and accelerates as we grow older. Dementia, on the other hand, is due to specific disorders that affect only a proportion of people.

It is understandable that, when people first notice some forgetfulness, they may worry that dementia is on its way – especially if others in their family have suffered from the condition. But dementia is much more than simply a loss of memory, and the forgetfulness may not even be part of mental decline! Many children and teenagers frequently forget seemingly silly things of everyday life.

Mental decline, though, can become annoying and troublesome, and there have been plenty of suggestions for keeping it at bay. There are the advocates of crossword puzzles and other brainteasers such as Sudoku. Others feel card games, chess and conversation are the secret of keeping an active mind. There’s increasing evidence that regular exercise retards mental decline; and there’s also evidence that speaking two or more languages helps.

Music may also hold a key. Astonishingly, many musicians can remember long pieces of music note for note and retain complex motor skills – skills often far beyond what the rest of us could ever do – until well into their advanced old age, sometimes even beyond a hundred years old.

Researchers in Toronto have now compared mental performance in 18 professional musicians and 24 non-musicians in late middle life*. The non-musicians were carefully selected to match the musicians – for example in education, general health and language skills – so that they differed only in musical skills. Most of the musicians played more than one instrument.

As might be expected, the musicians did better in tests of auditory skills than the non-musicians. They also did better in many of the other tests, including a composite measure of thinking ability. The results suggest that sustained music training or involvement is associated with improved aspects of mental functioning in older adults. People who have played musical instruments for many years seem to have less mental decline than their non-musical counterparts.

This was a small study with relatively few participants; but the researchers make the point that finding these differences in a small group is promising.

And even if you or your children don’t end up with a better-functioning brain in later life, playing music is a lot of fun.

The rise of sugar is a fascinating piece of our social history – from its discovery in India to an expensive luxury added in small quantities to some foods and drinks and now to the astronomical amounts we consume today. Its story includes establishing it as a crop in the New World, the development of slavery to fulfil the market in Europe, blockades in the Napoleonic War preventing its transatlantic shipment and the development of rival sugar beet manufacture in Europe. Is the latest part of the story that it is making us ill?

It’s uncommon to find someone who doesn’t like sugar. Although people vary in how much sweetness they enjoy, most of us gain pleasure from sweet foods and drinks. Sugar is quickly absorbed and the sweetness triggers the “reward centre” in our brain, making us feel good. Many of us turn to sweet things when we feel a bit low and in need of comfort or perking up; and sweet snacks such as chocolates or biscuits are often shared amongst friends or given as gifts.

But recently sugar has been getting some bad press. You have probably seen the headline accusation that sugar is “the new tobacco”, suggesting that sugar, like smoking, is the cause of widespread disease. Certainly, a large part of the population is now designated “obese”, which is worrying as a large amount of body fat increases the chance of major diseases such as diabetes, heart disease and stroke.

Others have countered by saying that it’s not specifically sugar that has led to the current levels of obesity and diabetes, but people eating too many calories from all types of food and drink.

So does our sugar consumption matter? The simple and straight answer is “yes”.

In fact, the subject has become so important that a consortium of Britain’s leading doctors and scientists have formed a group – Action on Sugar – to publicise the problem and what’s to be done about it.

Although defenders of sugar are right that there is no decisive evidence yet that sugar alone leads to obesity and disease, there can be no doubt it is a major contributing factor. The attractive taste of sweet food and drinks makes it easy to consume too many calories. And it is possible, as some doctors think, that fructose – which makes up half of the main type of sugar we eat – is not handled well by our bodies and is turned into fat that is linked with diseases*.

These days sugar seems to be in everything. The amount of sugar sold each year is truly stunning. It’s not just the sugar we buy for home use and the sugar you’d expect to find in desserts and confectionary. Processed food often sells more on taste than on nutritional quality, and added sweetness can make all sorts of food seem more appetising. This means sugar can be found in a huge variety of savoury foods, from ham to curries, soups to ready meals, pizzas to tins of beans. And there’s the large quantities of sugar that go into soft drinks, particularly fizzy drinks and so-called “sports drinks”, where one can may contain the equivalent of many teaspoons of sugar. Many people see these drinks as a major health hazard, and several states in the USA are taking steps to limit their sales.

Our bodies do not need sugar – however much we want it! It fulfils no nutritional need, and cutting back on added sugar makes a lot of sense. (Most nutritionists agree that there is no need to worry about the sugar naturally occurring in whole fruit and vegetables.) Reducing the sugar in your diet is a great help to achieving and maintaining a healthy body weight, and the health advantages of doing so are immense.

For all our sakes let’s wish Action on Sugar every success.

*We explain how your body processes fructose in our book, How to Live to 110: Your comprehensive guide to a healthy life

Microbes have a bad name. Most people just think of them as carriers of disease. Indeed, bacteria and other microscopic organisms are often pictured in TV adverts as tiny evil humans that every home-loving person should buy powerful antiseptics to eradicate.

Of course, a few microbes are the cause of major diseases, and some others bring less serious upsets. But it’s unfair of us to think of all microbes as harmful. Many of them fulfil useful purposes in the environment, such as breaking down waste to release chemicals for plants and animals to re-use. And some are vital for our health.

Each of us carries around a whole personal environment of different microbes ¬¬ –on our skin and inside our body. Researchers have coined the term ‘Human Microbiome’ for this, and recently they have been showing how individual it can be and exploring how it affects our health.

We acquire our first microbes as we are born, and our exposure to them increases rapidly over the first few years of life and continues into adulthood. As adults we carry around 10 microbial cells for every one of our own cells. That’s about 100 trillion microbe cells! Our gut alone contains about 2 kg of microbes.

These are not causing us any harm, and many are more than just passive passengers, coming along for the ride. We have learned a lot about the gut microbes, for example. They produce anti-inflammatories, pain killers and some vitamins as well as beneficial antioxidants. Recent research* has shown that people with cancer developing in their colons have a different microbial makeup in their colons to healthy people, which suggests some microbes may be protective against this. And fascinating laboratory work in mice** has suggested that some microbes might be implicated in body fatness, with other interesting work*** opening up about their association with metabolic changes related to type 2 diabetes.
With much of this work it’s far too early to suggest that actively changing gut microbes might be beneficial for humans. But these are interesting findings, and they undermine the simplistic view that microbes are there to be eradicated.

So many enjoyable things seem to be bad for us. But here’s some welcome good news – if you like nuts!

Some of the strongest evidence yet of the health benefits of eating nuts has come from two large US research studies*. These followed 76,000 women and 42,000 men over periods of 30 years and 24 years respectively. The participants were all health professionals, and periodically they were asked to fill in questionnaires about their lifestyle and what they were eating. These studies have produced a lot of good evidence about the health risks and benefits of different foods and aspects of lifestyle.

Recently, researchers have focused on what these studies show about eating nuts**. They found that the more times a person ate nuts each week, the less likely he or she was, on average, to have died during the study period or to have suffered cancer, heart disease or lung disease. Those who said they ate nuts every day did best, but even eating nuts once a week seemed to be associated with health benefits.

Unfortunately, the studies did not record what types of nuts people ate, nor how these were prepared – salted, spiced, roasted or whatever. It is likely, though, that most of the participants, as health professionals, would have been aware of the risks of eating too many salted products.

Interestingly, the frequent nut eaters tended not to be overweight. This does not automatically mean that eating nuts helps you keep slim: for example, the people who ate nuts might have led healthier lifestyles. The researchers therefore carefully took into account all the other factors that might have contributed to the health results they found with nuts, using statistical techniques to tease out what was associated with nut eating. It does indeed seem that eating nuts is associated with lower risk of the major diseases.

This is consistent with a range of earlier, smaller-scale studies, and with the widely supported Mediterranean Diet, which encourages eating 30g of nuts a day and has been shown to be effective at reducing the risk of those diseases.
Nuts contain vitamins, minerals and vegetable nutrients, unsaturated fat (oil) and proteins, and they contribute to dietary fibre.

If you are thinking of adding nuts to your diet, try to avoid added salt and be cautious about the calories in nuts. Because of the oil they contain, some types of nuts have quite a lot of calories for their size, and if you start eating nuts daily, you may need to cut back on the other calories you eat.

*The studies are the Nurses Health Study and the Health Professionals Follow Up Study.
** Link to nuts study: http://dx.doi.org/10.1056/NEJMoa1307352

Ask elderly people what they fear most and the commonest answer is losing their mind. Many people believe that this is inevitable, particularly the older you get.

Good news, though. That isn’t true, as a recent study* has shown.

Danish researchers compared the data for two groups of older people. One group, all people born in 1915, were studied when they were 95 years old. The second group – of people born in 1905 – had been studied previously when they were 93 years old. The findings were fascinating.

The two groups were similar in physical tests such as hand-grip, standing and walking speed, although the 1915 group were better in tests related to the activities of daily living.

The researchers then used standard methods to assess ‘cognition’ – the brain-based skills everyone uses to deal with everything from the simplest to the most complex processes. The group born in 1915 scored significantly better – even though they were older at the time of assessment. These 95-year-olds had clearer minds than the 93-year-olds born ten years earlier.

The researchers concluded that that more people are living to older ages with better overall functioning.

Incidentally, they also found that those born in 1915 had a 32% greater chance of living longer than those who were born in 1905.

*Link to the study abstract: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60777-1/abstract

Great news for over-60s who like gardening! And for DIY enthusiasts and people who enjoy similar activities around the home and garage.

A recent study* from Stockholm, Sweden, showed that men over 60 who did these activities daily were nearly a third less likely to suffer from diseases such as coronary heart disease, stroke and diabetes than men who were less active. Indeed, these men gained almost as much benefit as those who were more vigorously active.

The study followed 4,000 men aged over 60 for twelve years, and obtained their results by repeatedly questioning the participants about 12 different activities and through laboratory tests.

These findings are valuable because many people as they get older find that they can’t fully achieve the recommended levels of physical activity – or are disinclined to do so. The research shows how everyone can derive significant benefit from the activities they can do and enjoy doing.

Activities like gardening and DIY entail standing, using upper and lower limb muscles and walking, and this increases metabolic rate, maintains muscle power, preserves bones and affects body metabolism. Though everyday activities may not involve more than moderate levels of exercise, these effects have been shown to be of clear benefit.

This doesn’t mean that greater levels of physical activity are unnecessary. Part of the study showed those who were even more active gained an even greater reduction in risk of the diseases.

Our society has become increasingly sedentary both at work and in leisure time. Sitting for long periods is one of the riskiest things anyone can do, and yet many older and retired people – and, indeed, many younger people – spend much of their day sitting. This study helps confirm the advice that we should all reduce sitting to a minimum and find something we like doing instead.

One of the most significant studies in health has just celebrated 65 years since it started, and it’s still going strong.

Over those 65 years, residents of the small town of Framingham in Massachusetts, USA, have been participating in long-term studies looking at heart disease and its causes.

By the mid-1950s, the number of middle-aged men succumbing to coronary heart disease was causing serious concern – not least when several world leaders developed it. The disease had been on the rise since the start of the 20th century and the Framingham Heart Study set out in 1958 to establish what was behind this.

The study initially recruited more than 5,000 men and women, nearly a fifth of the whole population of Framingham. The researchers collected data about each of the participants every two years using interviews, clinical examinations and laboratory tests. The data covered participants’ lifestyle and environment as well as looking at their health and genetic profiles. This helped to show the importance of not smoking, taking enough physical activity, treating high blood pressure, avoiding obesity and the importance of blood fats in preventing coronary heart disease.

By 1971 the study had recruited a second generation of participants and in 1994 it extended its recruitment to reflect the changing population resulting from an influx of South Americans. 2002 saw the recruitment of a third generation. Over time, the study was widened to include other diseases, notably type 2 diabetes and dementia.

There were similar studies going on elsewhere but none was quite so comprehensive or prolonged. The Framingham study resulted in many papers published in leading scientific journals, and the work was widely discussed in scientific societies worldwide, greatly influencing research, debate and health policy.

Indeed, the findings in this and the other studies changed the way doctors looked at illness. Previously, most doctors thought of an illness as being caused by germs. If the germs could be killed or prevented from spreading, the illness would be eliminated. The Framingham discoveries required a rethink. This resulted in the concept of ‘non-communicable disease’ to explain much of modern illness and highlighted the importance of what we as individuals could do to prevent these diseases, as well as transforming the public health agenda.

There are questions over the future of this study, and whether it will continue to bring sufficient returns on the cost now that its primary objectives have been achieved. The US government has cut substantially its share of the funding.

But the fact remains that this study generated a novel way of looking at all disease and increased phenomenally our understanding of coronary heart disease.

We’re told the NHS is strapped for cash and it might get worse before it gets better. So, is there anything we can do as individuals? Actually, yes there is. Better still, it may even bring us financial benefits too.

A recent report* from Nuffield Health and the London School of Economics called “12 minutes more…” makes a strong economic case for taking more exercise. It is an approachable document well worth browsing through.

The health benefits of activity have been shown repeatedly: increased physical activity reduces the risk of heart disease and stroke, helps control type 2 diabetes, reduces blood pressure and body fat, improves aspects of mental health and much more. As a result, governments around the world – including our own – have recommended we all do at least 150 minutes of moderately physical activity a week.

Unfortunately, the report concludes that the majority of us don’t achieve this level. But it goes a stage further by looking at what this means economically for individuals and for the country.

First, there’s the personal burden when someone contracts one of the long-term diseases that physical activity might have helped prevent. Quite apart from the unpleasantness of the disease itself, there is the potential for loss of earnings and the impact this has on one’s own life and the lives of family members.

Secondly, there’s the less obvious but even greater burden illness puts on society as a whole through the loss of economic activity and the demands placed on the NHS and other organisations. The sums involved are quite staggering. If everyone did the recommended amount of exercise, the report authors calculate this would save the NHS £257 million per year. Mental health savings – taking account of savings for the NHS, earnings and welfare – would be over £6.3 billion.

On an individual level, the report estimates that the average household income of those that do moderate sports is more than £6,500 a year higher than inactive households. These people are also more likely to be employed.

This report contains a lot of detail establishing how all these figures were calculated. But even if only a proportion of these staggering amounts could be saved it shows that we can all do our bit by increasing our activity levels.

Many economists believe that if something doesn’t hit our own pocket directly we tend to ignore it – and that certainly seems true for physical activity. It’s only when a report like this spells it out to us that we can see clearly the enormous cost inactivity is having.

And the solution is hardly a drastic one. The report’s title “12 minutes more…” comes from its bottom line finding: that all it would take to improve our health and personal finances, and to relieve the financial pressure on the NHS, is an increase in the amount of activity we do on average of just 12 minutes a day.

*Link to the report: http://www.nuffieldhealth.com/sites/default/files/inline/Nuffield%20Health_%20LSE_Low-Fitness_Report.pdf

People are vegetarians for a variety of reasons. Some simply dislike the taste of meat products, while for others it is ethical or cultural aspects that are important. Whatever the reason, it seems a major benefit that many vegetarians enjoy is better health.

A recent large-scale investigation supports this. The Adventist Health Study in North America looked at dietary information for 73,000 men and women who were followed for 5 years. These were grouped into categories according to their diet: nonvegetarian, semi-vegetarians (i.e. people who eat meat or fish but at most once a week), vegetarians who eat fish, vegetarians who eat eggs and dairy products, and vegans.

Around 2,500 of these people died during the study period, and the researchers were able to compare the number of people in each diet group who died. Overall – after correcting for other factors that might have had an influence – the results suggested that vegetarians were about 12% less likely to die of any cause during the period than the meat eaters. The group that came out best were the vegetarians who also ate fish, and the vegans also did well. The benefits seemed to be greater for men than women.

In particular, the vegetarians were less likely to die from cardiovascular, kidney and endocrine diseases. Interestingly, the researchers didn’t find a difference in the number of deaths from cancer.

Studies like these cannot prove definitively that vegetarianism was the cause of people living longer: there is always the possibility of some hidden factor not taken into account. But this was a large study carefully carried out, and it does seem to support the health benefits of a vegetable-based diet. At the very least it should help vegetarians strengthen their resolve to continue, and give the rest of us reason to think about what we eat.

There is other evidence that cutting back on meat-eating is a good idea (see, for example, Meat and Diabetes). But it is worth remembering that changing other aspects of your diet – such as cutting back on salt and sugar, eating plenty of vegetables and fruit, and looking after your body weight – may have as great an impact on your health.

The sun is here! For the first time in several years, much of the UK seems set for a proper spell of summer weather.

Sunshine helps us feel good and allows our bodies to make vitamin D that is important for the health of our bones and for helping to prevent heart disease and cancers. But too much exposure to sunlight brings dangers.

A recent publication* from the Office of National Statistics shows an increase in cancers in the UK and draws particular attention to skin cancer. Between 2002 and 2011, malignant skin cancer increased by 56% in males and 38% in females. It is thought this might be due to sunbathing and the use of sunbeds.

The daily use of a good sunscreen helps protect your skin from prolonged exposure to the ultraviolet (UV) light that induces skin cancer. This can literally save your life.

What you might not realise is that daily use of a sunscreen can also protect your skin from ageing processes and keep it looking younger. This has been demonstrated in a recent, timely, study** carried out in Australia.

This study followed 900 middle-aged adults for over 4 years in a controlled trial and compared a group who used sunscreen daily with a group who decided themselves if and when they used sunscreen. Some of the participants also took beta-carotene tablets – an antioxidant that some people take to lessen skin ageing – while others took a placebo for comparison.

The researchers used an established method for assessing skin ageing, and showed that skin ageing was reduced by 24% in the regular users of sunscreen. They found no benefit from taking the antioxidant tablets.

Enormous amounts of money are spent each year by people trying to keep their skin looking young. Some of these commercial products are effective, but many are expensive and can be of dubious merit.

It is good to have evidence that something as simple and easily available as sunscreen used daily can make a significant difference to skin ageing.